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General NPI Number Information
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NPI Number | 1922549849
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Entity Type | Individual
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Provider Name | NICOLE KIPLEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/10/2017
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 619 E 5TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90013-2109
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Country | US
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Telephone | 213-537-0822
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Fax |
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Provider Business Mailing Address
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Address Line | 2116 ARLINGTON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90018-1353
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Country | US
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Telephone | 616-916-9846
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 69514
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 86511
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License Number State | CA
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